Acute poisoning with phenothiazine neuroleptics. Phenothiazine coma

Abstract

The article summarizes the authors' long-term experience in the diagnosis and treatment of acute poisoning with phenothiazine derivatives and presents data on the epidemiology of the effects of phenothiazines on the central nervous system. The original classification of acute phenothiazine intoxication confirmed by electrophysiological studies of the brain is given. The involvement of deep brain structures in the pathogenesis of acute phenothiazine coma has been confirmed. Based on studies of visual evoked potentials, the absence of inhibition of deep brain structures despite a pronounced comatose state is shown. In some cases, repeated light stimulation provoked hypersynchronization of evoked potentials and the appearance of convulsive manifestations in the clinic, which was regarded as a state of parabiosis (according to N.E. Vvedensky). Emergency treatment measures for phenothiazine poisoning associated with accelerated detoxification of the body mainly using active methods such as peritoneal dialysis, intestinal lavage with constant monitoring of respiratory function and the cardiovascular system, are presented. The materials of the article will help doctors of intensive care and toxicology departments to improve the quality of diagnosis and treatment of these pathologies.